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The Repair of Early Trauma: A “Bottom Up” Approach


By
November 2, 2017

Written by Dr Shoshanah Lyons, Clinical Psychologist and Clinical Director of Beacon House, a specialist mental health and trauma team based in Sussex.

Summary
Did you know that when we say a child has an attachment disorder, it is often not the whole picture? It is only one part of a seven-piece jigsaw puzzle called ‘developmental trauma’. By putting together the puzzle, we can understand how a child’s adverse childhood experiences have shaped their emotional world and outward behaviour. Once we understand this, we can then work with a child to help them with their developmental trauma using an innovative therapeutic approach called the ‘Neuro-Sequential Model of Therapeutics’. This model recovers and repairs each part of a child’s brain in a specific, phased and effective order. We need to ensure that the child’s different environments work together using this model as a whole; including home school, therapy and even the GP – to ensure the child’s best chances for recovering from their trauma and loss. Developmental trauma can be repaired – if we get the order and type of support just right.

Attachment is adaptive
The ideas described here are a holistic and whole life approach designed to help a child and their parent/carer to recover and repair from early trauma and disrupted attachment. It is an approach based on cutting edge research, and can be applied by everyone who knows a child who has been through chronic stress or repeated trauma.

The majority of people immersed in the world of working with or caring for vulnerable children have been taught about attachment styles. They understand the idea of ‘insecure attachment’ and that a child will either be ‘insecure avoidant (disconnected), ambivalent (highly emotional and resistant) or disorganised in their attachment. This is the child’s best way of coping with threat and danger.

Psychologist, Dr Patricia Crittenden, has now provided us with a heavily researched modern attachment theory that helps us take this further.
Crittenden has shown us that frightened children are not actually disorganised in their behaviour, but in fact they always organise themselves around danger by using a fluid combination of attachment behaviours to survive the environment they are in at that given moment. Children often have a ‘default’ attachment pattern, but they do not have one static attachment style. This helps us to understand why many vulnerable children are shut down (seen as “good”) at school yet fall apart at home; or vice versa. It also helps us to understand why it can be so hard for some professionals to really see what is going on in a child’s emotional world, as vulnerable children are so incredible at adapting to their environment.

But is attachment theory enough?
We (parents and professionals) have been so focussed on attachment that the other six pieces of the jigsaw puzzle are often not appreciated nor addressed. Without putting all these pieces together, working with a child who has early trauma is less likely to be effective and more likely to compound feelings of shame and inadequacy and ultimately failure.

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